BACKGROUND: TBI is a neurological emergency requiring surgical intervention at times. Traditional surgeries are associated with lots of complications. Hence, there is a need for a less invasive and yet effective surgical approach for TBI mass lesions.

METHODS: A total of 60 patients (30 patients in each surgical group) with mild to moderate acute TBI who fulfilled the inclusion and exclusion criteria were enrolled in the study over a period of 17 months.

RESULTS: There was statistically significant difference in the duration of operation, pain score, incision length (p<0.0001each) and hospital stay((p=0.0064)) which was significantly lower in Minimal invasive surgery (MIS) group.

CONCLUSION: Minimal invasive surgery has statistically significant advantage over standardized surgery in the terms of being done under local anesthesia, shorter duration of operation, shorter incision length,  decreased post operative pain and shorter hospital stay. There was no clear advantage in terms of GOS and GCS